Peripheral Nerve Injury May Cause Substantial Disability

Patients report disability, pain, and cold sensitivity six months or more after nerve injury

FRIDAY, May 27 (HealthDay News) -- Patients with peripheral upper-extremity nerve injury may have substantial disability and pain at more than six months following the injury, according to a study published in the May 18 issue of The Journal of Bone & Joint Surgery.

Christine B. Novak, Ph.D., from the University of Toronto, and colleagues investigated the biomedical and psychosocial factors associated with disability at a minimum of six months following peripheral upper-extremity nerve injury in 158 patients. Participants with an average age of 41 years were followed up between six months and 15 years after injury, and were assessed by patient self-report questionnaires (Disabilities of the Arm, Shoulder, and Hand Questionnaire [DASH]), and questionnaires on pain and general and mental health. DASH scores were compared for age, gender, marital status, education, geographic location, Workers' Compensation/litigation, work status, income, affected limb, nerve injured, and time since injury, and predictors of DASH scores were evaluated.

The investigators found that patients with brachial plexus injury, or those who received Workers' Compensation, were involved in litigation, or were unemployed, had significantly higher DASH scores. The DASH scores correlated significantly with pain intensity (r = 0.51). In a multivariable regression analysis, 52.7 percent of the variance in the final model was explained by 10 DASH score predictors: pain intensity, pain catastrophizing scores, brachial plexus injury, time since injury, age, work status, cold sensitivity, depression score, Workers' Compensation/litigation, and being female.

"Patients with a peripheral nerve injury report substantial disability, which is predicted by a combination of biomedical and psychosocial factors," the authors write.